Electroconvulsive therapy is a type of psychiatric therapy which involves the controlled introduction of electric currents to the brain for the purpose of inducing a convulsion which will alter the patient's brain chemistry. This treatment is primarily used in the management of depression, although it also has been utilized to treat patients with schizophrenia and mania. Many people are surprised to learn that electroconvulsive therapy is still in widespread use around the world, as the procedure is extremely controversial in many regions.

This method was developed in the 1930s, and initially, people had good cause to be wary of it. Early electroconvulsive therapy involved large amounts of electricity, and an imperfect understanding of brain chemistry and depression. Patients could experience severe side effects from electroconvulsive therapy, including memory loss, seizures, and death. Psychiatric patients were also rarely consulted about the therapies used to treat them, and most electroconvulsive procedures lacked informed consent, which is now viewed as a key requirement for all medical procedures and treatments.

Despite the fact that the early years of this treatment were deeply flawed, psychiatrists continued using electroconvulsive therapy to treat their patients, and they refined the treatment to make it more effective. Modern electroconvulsive therapy is conducted very differently from early procedures, and informed consent is a critical part of the procedure, with the patient playing an active role in treatment decisions, and making a choice to opt for electroconvulsive therapy, rather than being forced to undergo the procedure.

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In an electroconvulsive therapy session, the patient is anesthetized and given muscle relaxants. Electrodes are placed on the skull, and a specialized machine is used to deliver targeted electric shocks. The patient does not experience convulsions because he or she is anesthetized and drugged, but the brain activity is identical to that of a body in full convulsions, releasing a flood of neurotransmitters. Patients may undergo a dozen sessions at varying intervals in the course of treatment.

Psychiatrists generally only recommend electroconvulsive therapy to patients who have not experienced success with other treatment methods. One of the major risks of the procedure continues to be memory loss and confusion, which may be temporary or permanent. Everyone's brain chemistry is slightly different, and there is no way to predict exactly how a patient will respond, although steps can be taken to make the procedure as safe as possible.

Because of the stigma associated with this therapy, patients are sometimes shy to discuss it with friends and family, and they may express deep misgivings when the therapy is recommended. Patients are encouraged to discuss the pros and cons of the procedure with their psychiatrists, however, and to consider soliciting a second opinion from a knowledgeable psychiatrist who can provide additional information.

Discuss this Article

MangokipperPost 3

Over the period of eight years, I had 169 ECT sessions. It never worked for very long and I feel it has ruined my life. My childhood and education are gone, and five years after my last treatment, I still struggle with day to day life due to my memory and cognitive impairment. I'm only 34.

Yes, I signed the consent forms, but I was bullied into it by staff who said that if I didn't sign them, I'd be forced into having it anyway. I was never told of the devastating after effects -- only that there would be a slight memory loss, around the time of treatment.

I fall under the criteria for acquired brain injury, but the NHS

will not give me a diagnosis. I imagine they're worried that I'll sue. If I had this diagnosis, more specialist services would open up and I'd get the help I need.

Today's ECT still uses large amounts of electricity. The anesthetic and psychiatric medication that the patient is likely to be on, raises the seizure threshold more that if there was no anesthetic or drugs. Once I had woken up after a session, I had burst my lip, and pulled all the muscles in my back and legs. I later found out that they had given me three shocks in the session. By the time they got around to the third shock, the muscle relaxant had worn off. They all had to jump on top of me as I had a full unmodified seizure.

I'm not completely anti ECT, and I don't know what the situation in the USA is, but in Britain, lack of informed consent, bullying and problems with the ECT process still go on.

My sister had ECT in Johannesburg South Africa in the late 1980s. My mother and brother flew to Johannesburg and tried to prevent further "therapies," but the psychiatrist very arrogantly refused to see them, an d would not discuss anything about my sister's case with them, even with her permission.

My sister had permanent severe memory loss and her character changed. She committed suicide about two years after the ECT.

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